Archives for January 2011

Israeli device for heart failure victims helps local.

PHOTO: COURTESY

A 35-year-old Kiryat Malachi man this week became the first in Israel to undergo the implantation in his chest of a unique pulse generator – developed in Israel – that delivers electrical impulses to the heart for treatment of moderate to severe heart failure.

Called Optimizer, the device is made by the US company Impulse Dynamics and has been proven successful on patients in the US and Europe.

Kobi Haddad, who is waiting for a heart transplant, underwent the procedure at Kaplan Medical Center in Rehovot and immediately benefited from improved heart performance; similar heart failure patients will soon follow.

His Kaplan cardiologist, Prof, Kobi George, said the Optimizer is a “revolutionary device that allows cardiac insufficiency patients waiting for a transplant to improve their quality of life and daily functioning.”

After the procedure, Haddad said he had great hopes that “with the help of the wonderful and professional doctors and nurses in Kaplan, I will be able again to carry out tasks that healthy people find completely trivial. The sensitivity and hope they gave me here give me real optimism that I will be able to have a normal life even without a heart transplant.”

George, who is chief of cardiology, along with Dr. Ofir Paz and Dr. Moshe Suissa, implanted the device, which is suited for “patients suffering from significant decline in the ability of their heart muscle to contract” and thus have a reduced amount of oxygenated blood flowing through their blood vessels.

Such patients find it difficult to perform the simplest routine tasks such as walking, and their condition is liable to speedily decline, they explained.

Cardiac insufficiency is the main cause of death in people over the age of 65 and the most common cause of hospitalization in this group. Recent advances in cardiology have made it possible to extend the lives of cardiac patients, but many of them still suffer from insufficiency.

Unlike other heart-failure devices, the Optimizer works by strengthening the pumping force of the heart. The Optimizer System modulates the strength of the heart’s contractions rather than controlling its rhythm.

Patients who qualify for the Optimizer System undergo a surgical procedure similar to putting in a pacemaker. Typically, the surgery takes about four to five hours and requires three leads to be implanted into the heart.

The New York-based company’s Israeli technology research center that developed the Optimizer, Impulse Dynamics (Israel) Ltd., is located in Ness Ziona. The device, first tested in 2001, looks like an ordinary pacemaker or defibrillator and is installed in a similar way; it operates on an internal battery that is charged from outside the body once a week for about 90 minutes.

Every month, 20 or 30 patients at leading medical centers in the US and Europe are routinely implanted with the Optimizer.

According to University of Texas-Southwestern Prof. Jose Joglar, who is co-investigator of a study on the Optimizer, the device “could benefit up to two-thirds of advanced heartfailure patients who may not qualify for other kinds of therapy.”

Rehovot speech expert aids 21-year-old who allegedly lost ability to speak from emotional trauma caused by encounter with security forces.

PHOTO: KAPLAN MEDICAL CENTER

The ability to speak – lost eight months ago by a 21- year-old Palestinian allegedly from the emotional trauma of an encounter with security forces – has been restored by a clinical communications specialist at Rehovot’s Kaplan Medical Center.

The humanitarian gesture was that of Pnina Erenthal, who has much experience in treating psychogenic aphonia.

The patient was Muhammad Devabassa, a resident of Tarkomia near Hebron and a construction worker inside Israel. After the encounter with the security forces, he was taken to a different hospital and tried to speak, but found to his horror that he couldn’t say a word. Erenthal, who heard about the case, recently tried to locate him through Doctors Without Borders and his family physician.

“I was sure I could restore his speech,” she said, “on the basis of my extensive experience in treating psychogenic aphonia.”

She finally found him and volunteered to treat his condition at Kaplan; approval for his entrance was granted by the authorities.

All the three symptoms for the condition were present, she said. There was a lack of coordination between the voice and the vocal cords, which were not diseased; a difficult traumatic condition; and relatively quick disappearance of the problem. She tried to help him make nonverbal throat sounds such as a cough or gargling sound and reduce the muscle tension in his voice box. She also helped him feel safe and provided a friendly environment.

Erenthal said she “took the weak voice and helped him build it into sentences and texts. The first thing he said was about the trauma he had suffered,” but she did not provide details.

“I immediately called his family doctor to tell her the treatment had succeeded.

Erenthal was told by the doctor that she had already been informed by the Betzelem organization, which deals with humanitarian cases.

Devabassa said he was very excited by Erenthal’s initiative to restore his voice.

“I want to study industrial engineering and management in university, and now I hope I will be accepted. Thanks so much to Pnina – she is a dear woman – and to Kaplan Medical Center which arranged all the authorizations.”

The device that made encounter possible, called BAHA for bone-anchored hearing aid, was added to the basket of health services only last year.

Forty years after Evelyn Pinto went deaf as a child from immersing herself in a wading pool filled with infected water and after Ilan Yamit was born deaf, they both underwent surgery for implantation of a new hearing device at Kaplan Medical Center in Rehovot.

After both began to hear at the hospital, Yamit identified Pinto as a former neighbor in Yavne whom she last saw in 1976. They recently celebrated their unplanned reunion in the hospital by actually talking to and understanding each other.

Pinto, who is 10 years older than Yamit, is a professional cook in a child rehabilitation center who came on aliya from Morocco. While attending a summer camp, she completely lost her hearing after her ears were exposed to the infected water. She has since used sign language to communicate.

Yamit, who works in supply services and who never heard a word until the implant due to congenital deafness, met Pinto in the wards of the ear-nose-and-throat department.

“We used to play together near our homes in Yavne,” he said with emotion. “At the age of 15, I received rabbinical ordination – becoming the youngest rabbi in the country – but as I devoted myself to my studies and wrote books, I didn’t see my neighbors. When I saw Evelyn in Kaplan, I had no doubt it was she. Now we can exchange experiences.”

He left the neighborhood 18 months ago after divorcing, but his ex-wife and children still live there.

Pinto said it was very odd to meet – in the corridor outside the operating theater – a childhood friend and neighbor who had lived 30 meters away.

“I know Ilan’s parents, and know I will get to get to know him again,” she said.

The device that made their encounter possible, called BAHA for bone-anchored hearing aid, was added to the basket of health services only last year. The implanted system works through direct bone conduction and in 2002 was approved by the US Food and Drug Administration for the treatment of unilateral sensorineural hearing loss.

It is meant for people who cannot benefit from conventional hearing aids; both Pinto and Yamit couldn’t wear them because of recurrent infections in their ears.

BAHA allows sound to be conducted through the bone rather than via the middle ear, It consists of three parts – a titanium implant, an external abutment and a sound processor. The system works by enhancing natural bone transmission as a pathway for sound to travel to the inner ear, bypassing the external auditory canal and middle ear.

The implant is placed during a short surgical procedure and over time naturally integrates with the skull bone in a process call osseointegration.

For hearing, the sound processor transmits sound vibrations through the external abutment to the titanium implant. The vibrating implant creates vibrations within the skull and inner ear that stimulate the inner ear’s nerve fibers, allowing hearing.

The device is used to rehabilitate people with conductive and mixed loss hearing impairment such as Pinto, who suffered from chronic infection of the ear canal, congenital ear malformation, such as Yamit, and people with a single-sided hearing loss as a result of surgery for a vestibular tumor of the balance and hearing nerves. It is used both in adults and children.

The device costs $4,000 in the US plus the cost of surgery, but in Israel it is supplied to suitable patients by their health funds. The only manufacturers are the Sydney, Australia-based Cochlear Limited, which registered BAHA as a trademark, and the Gothenburg, Sweden-based Oticon Medical.

Kaplan ear surgery specialist Dr. Yitzhak Poriya, who performed both implant operations, and Dr. Doron Halperin, head of the hospital’s ear-nose-and-throat department, said Pinto shouted “Wow!” with great emotion and tears in her eyes when she found she could hear again.

Pinto added that for years she had no hope of being a “normal person.”

When she learned of the BAHA, she didn’t hesitate to undergo the surgery and hear like everyone else.

“Until now, my eldest son, who is 13, has helped me understand what his 10- year-old sister was telling me. Now, thanks to the incredible staffers at Kaplan, I can hear everyone.”

Crowding in hospitals around the country has intensified, the Health Ministry said on Sunday.

Occupancy rates in the internal medicine departments at Ashkelon’s Barzilai Medical Center, which treat mostly the elderly and those with chronic diseases, have reached 200 percent – meaning many beds are in the hallways.

The director-general asked that additional patients not be admitted until further notice.

This is happening even though the winter has been quite mild, with little cold and rain and thus lower rates of flu complications.

At Kaplan Medical Center in Rehovot, the internal medicine units are full and emergency department is operating at 160% occupancy. It asked the ministry for permission to refuse new admissions, but this request was not approved.

Pediatric wards at Wolfson Medical Center in Holon are at 200% capacity, and the pediatric emergency department is also full. The ministry also refused management’s request to turn away new patients.

At Petah Tikva’s Schneider Children’s Medical Center and Haifa’s Carmel Medical Center, all beds are full, and at Emek Medical Center in Afula, the departments are almost all at 200% capacity.

The Health Ministry said it was aware of the rise in hospital occupancies and is working with Magen David Adom to identify hospitals where one could still bring ambulance patients. It has allowed hospitals to increase shifts with additional doctors and nurses.

Over the last half-year it has warned the Treasury about hospital crowding; the Finance Ministry has agreed to an expansion of only 960 beds over the next six years, which the Health Ministry said it hoped would help reduce pressures.

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